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Branded NSCLC drugs in Indonesia cost almost three times as much as generic drugs. Their high prices are expected to compensate manufacturers for the decline in sales volumes, as generics is the first line and often, the only form of drug treatment for NSCLC in Indonesia.

New analysis from Frost & Sullivan (pharma.frost.com), The Non-small Cell Lung Cancer Drug Market in Indonesia, finds that the market earned revenues of $16.0 million in 2010 and estimates this to reach $26.0 million in 2015.

Branded drugs are sold at price-per-cycle and their volumes drop when the price-per-cycle crosses $850. As the price-per-cycle of generic drugs has not reached the $850 mark yet, their volume is expected to continue rising.

The prices of both generic and branded NSCLC drugs could see a spurt along with the increase in transportation and oil costs, since active pharmaceutical ingredients (APIs) are generally imported. However, the market will be sustained by the increasing incidence of NSCLC caused by the high rates of smokers.

"The percentage of adult male smokers has increased from 53 percent in 1995 to 66 percent in 2010; and while only 4.2 percent of adult Indonesian women smoke, their numbers have also increased from the 1.7 percent in 1995," says Frost & Sullivan Research Analyst Poornima Srinivasan. "Furthermore, approximately 97.0 million non-smokers are routinely exposed to secondhand smoke (SHS) and 70.0 percent of children under the age of 15 are regularly exposed to SHS, expanding the market for NSCLC drugs."

Eugene van de Weerd, Country Director, Frost & Sullivan – Indonesia notes that Indonesia also has one of the highest number of child smokers in the world, with 25.0 percent of children over the age of 3 having tried cigarettes. This is likely to cause the onset of tobacco-related illnesses, which includes NSCLC, to occur at earlier ages.

"In addition, cigarettes are relatively cheap and taxes levied by the government, at 37.0 percent of the sales price, are low in comparison to the global standard of 70.0 percent," Eugene says. "Without higher cigarette sales taxes and comprehensive cigarette cessation programs, smoking rates will remain high in Indonesia and increase the likelihood of cancer."

Both patent expirations and the introduction of novel NSCLC drugs will widen the drug options for patients, even though the standard first line of therapy will continue to be a platinum-based generic chemotherapy combination. The NSCLC market in Indonesia will remain loyal to generic drugs due to the low level of patient affordability. While rising incomes will make private insurance affordable to the public in due course, currently, only 48 percent of the population has health insurance.

Healthcare expenditure has steadily increased, from $6.80 billion in 2006 to an estimated $19.80 billion in 2010. It is projected to rise to $33.80 billion in 2015, at a compound annual growth rate (CAGR) of 11.3 percent. Currently, only 13.0 percent of private sector workers have health insurance, but this is expected to improve with robust growth in the gross domestic product (GDP).

So far, pharmaceutical companies have been unable to tap the market’s potential, as inadequate screening programs and often innocuous early signs of the disease impede the likelihood of an early diagnosis. As most patients are in the advanced stages of the disease, only a small percent of patients are benefitting from drug therapy.

Greater healthcare access for patients and quality healthcare infrastructure will be necessary to persuade patients to seek therapy and render it unnecessary for wealthy Indonesians to travel abroad for treatment. Public private partnerships, along with private investments, will be crucial for the market to upgrade its facilities and expand.

"Sponsoring disease awareness programs that identify the risk factors and early warning signs of NSCLC is one way to encourage the undiagnosed to detect the disease early," notes Srinivasan. "Also, developing strong relations with hospitals and clinics, along with a solid market presence, is essential to capture market shares in the Indonesian marketplace."

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